Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.39 / $276.10 / $747.65	Facility	26	$82.39	$276.10	$747.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.33 / $438.48 / $1,565.46	Professional		$246.33	$438.48	$1,565.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $192.43 / $235.43	Professional	26	$82.39	$192.43	$235.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.94 / $168.49 / $1,053.10	Professional	TC	$163.94	$168.49	$1,053.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $88.30 / $157.68 / $192.10	Professional	26	$88.30	$157.68	$192.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $454.88 / $486.22 / $509.89	Professional		$454.88	$486.22	$509.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $150.66 / $161.03 / $170.55	Professional	26	$150.66	$161.03	$170.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $304.23 / $325.18 / $339.36	Professional	TC	$304.23	$325.18	$339.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $475.26 / $475.26 / $475.26	Facility	26	$475.26	$475.26	$475.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.71 / $599.67 / $912.49	Professional		$353.71	$599.67	$912.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.04 / $188.26 / $243.38	Professional	26	$100.04	$188.26	$243.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.09 / $406.85 / $668.07	Professional	TC	$245.09	$406.85	$668.07
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $801.92 / $801.92 / $801.92	Facility	26	$801.92	$801.92	$801.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $392.60 / $633.00 / $3,101.53	Professional		$392.60	$633.00	$3,101.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $109.89 / $174.67 / $660.44	Professional	26	$109.89	$174.67	$660.44
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $277.89 / $470.29 / $2,625.91	Professional	TC	$277.89	$470.29	$2,625.91
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $293.94 / $302.50 / $475.26	Facility	26	$293.94	$302.50	$475.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $492.65 / $631.94 / $912.49	Professional		$492.65	$631.94	$912.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $92.79 / $238.14 / $568.05	Professional		$92.79	$238.14	$568.05
United Facility/Professional Professional Modifier Low / Median / High Price $375.89 / $625.99 / $755.00	Professional		$375.89	$625.99	$755.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.88 / $172.05 / $214.49	Professional	26	$105.88	$172.05	$214.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $277.89 / $457.28 / $519.66	Professional	TC	$277.89	$457.28	$519.66